Healthcare Provider Details

I. General information

NPI: 1154579605
Provider Name (Legal Business Name): CHRISTOPHER ELLINGTON BMBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 AIRPORT BLVD STE 2000
PENSACOLA FL
32504-8615
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-6933
  • Fax: 850-416-6934
Mailing address:
  • Phone: 904-450-6063
  • Fax: 904-539-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME172201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: